Provider Demographics
NPI:1619449204
Name:ATALLA ALBEIRAT, HANIN EDSON
Entity Type:Individual
Prefix:
First Name:HANIN
Middle Name:EDSON
Last Name:ATALLA ALBEIRAT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4001 S DIXIE HWY
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33405-2601
Mailing Address - Country:US
Mailing Address - Phone:561-906-9270
Mailing Address - Fax:
Practice Address - Street 1:4001 S DIXIE HWY
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33405-2601
Practice Address - Country:US
Practice Address - Phone:561-906-9270
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-12-20
Last Update Date:2023-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA80054183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist